AI-based prediction of dengue incidence using climatic, environmental, and socio-demographic factors: an ensemble random forest approach with agile system development

BACKGROUND: Dengue transmission in Indonesia is shaped by interacting climatic, environmental, and socio-demographic factors, yet most forecasting systems remain static and vulnerable to data shifts. There is a critical need for adaptive, data-driven early-warning frameworks that integrate multiple predictor domains while preventing methodological biases such as information leakage. This study aimed to develop a Random Forest (RF)-based predictive model embedded within an Agile System Development workflow to forecast monthly dengue case counts in Yogyakarta. METHODS: Monthly dengue case counts from five districts (2017-2022) were modeled using multi-domain predictors. All preprocessing steps-including imputation, standardization, correlation screening, VIF diagnostics, and Negative Binomial GLM-based feature screening-were performed exclusively on the 2017-2021 training subset, with parameters applied unchanged to the 2022 test set. The GLM served solely as a leakage-free exploratory screening tool. A Random Forest model was trained using optimized hyperparameters (500 trees, max depth 10) and evaluated through temporal testing. Model reliability was assessed using calibration curves, prediction-interval metrics, and a one-month early-warning classification evaluated with sensitivity, specificity, PPV, and NPV. RESULTS: The RF model achieved strong predictive performance (R² = 0.86; RMSE = 5.72), exceeding the GLM benchmark (R² = 0.64). Rainfall lag-1, temperature, and humidity emerged as dominant predictors, complemented by built-up area and population density. Calibration indicated good agreement across routine transmission ranges, with reduced reliability during outbreak peaks. The early-warning component demonstrated high sensitivity (0.82) and strong negative predictive value (0.86), supporting its use as a decision-support indicator of elevated transmission risk. CONCLUSION: The proposed Agile-AI framework demonstrates the potential to deliver accurate dengue risk predictions with interpretable uncertainty estimates within a flexible, multi-domain early-warning architecture. While external validation and further refinement are required, the framework offers a scalable foundation for adaptive dengue surveillance and targeted vector-control decision support in dynamic tropical settings.